Tuesday, August 30, 2011


A beautiful penultimate morning of August here in Toronto that makes me feel renewed. That renewal also comes because of the seems-like-very-solid-and-sensible-advice-to-me advice that I got yesterday from a therapist named Damien at Athlete Care yesterday. I'd gone in to see him (my friend Ilse had recommended him highly) about this fallen transverse arch situation I've been living with since June.

Of course the failing of a piece of my body is disturbing. So it's been an odd summer as I try to come to terms with it. I've bought Birkenstock inserts to wear in my shoes and a new cushy pair of runners. But the basic message I got at the foot clinic was that i would need to depend on those inserts, and on wearing shoes in the house and never going barefoot, from now on. Even that I swallowed (grumbling, natch! but I did accept it).

But then my ankle started to hurt, with an intermittent pain, sometimes when I used it, sometimes after. Not good. Clearly whatever adaptations i was consciously making, and my body was making on its own, were doing damage or shifting things around, in a way that seemed to be making the situation worse. Time to rethink, I decided. Was there something going on centrally that was somehow causing all this? Maybe I needed to dig deeper? Cranio-sacral perhaps could help?

But no, really, it all felt lke a functional problem that I was failing to understand. Thus Damien.

His advice? Strengthen, stregthen, work on getting the muscles in the foot and lower leg strong to support the (now weaker) ligaments. He had me stand on two feet and go up onto the balls of my feet as high as possible, then down, and again and again. Then he asked me to try it just on the one left (injured) foot. Yikes! It wobbled and was unsteady. There, he said, that's what you need to stregthen. I'm to go up and down, on two feet before a walk or before getting going in the morning, just to increase blood flow to the muscles, and then do it on the injured foot, up-down-up-down, as often as I can in the day, in reps. The other exercise is to use the foot and ankle to pull against resistance. I mean I can do ankle circles, but it's a more effective strengthener to pull against resistance. (I hook my foot under the edge of a counter and use it to pull me up into a sitting position.)

I'm feeling so energised by this. Aha, I can help myself! Yes, it's a brighter picture altogether, Damien's view (no need for orthotics, once you're stronger you'll be fine barefoot etc), but the energising aspect is that it depends on me, it's up to me, and doesn't rely on outside aids or medications or tricks or... Damien's opinion (and of course not everyone would agree, but one can pick one's advice as one picks anything else, no?) is that most problems are a result of insufficient muscle strength or else overuse, too much pounding. And as we age, we need to focus even more on maintaining muscle strength to support our decreasingly elastic tendons and ligaments.

Sounds like a plan.

Now what's the emotional or intellectual equivalent of this physical advice about sustainable fitness and freedom from injury or impediment?

If I start from the same approach, then I can frame the issue this way: as we age we lose resilience, not just of ligaments etc but also some mental elasticity. We're no longer able to multi-task as easily. If we're too overloaded with different thoughts, we start to forget names or show some other sign of slippage. It's not a pretty sight and it can be very distressing (is this Alzheimer's? is the first panicked thought when it happens).

Clearly the first step is to try to keep our heads clear of unnecessary clutter. That would be for example fruitless worrying about the future or the past or...let's just leave it as fruitless worrying. The other kind of clutter is that which comes when we let ourselves think about too many things at once. With the internet always beckoning, it's easy to slip out of a task and into checking email or looking at the latest tweets. That shifting back and forth builds up debris and clutter that stops us from thinking clearly. It turns us all into ADD sufferers, mental magpies leaping from thing to thing and unable to setttle on anything or think about any one thing in a sustained way.

And that leaves us without the ability to think things through clearly.

I'm just feeling my way here, but the advice I'm trying to give myself, and to live by, is to make a list for the day, and try hard to stick to it, to move from task to task sequentially and not to think much about the next one until this one is done. (And to not check email every half hour either!) The limited forward planning required as I make the list and (loosely) structure my day is very steadying I find.

Those of you who work freelance will probably recognise what I'm talking about. Maybe those of you with jobs that are already structured won't know what I mean. But in your off-hours you may have these distracted and unproductive patterns. Mine are for sure in need of tidying up.

Today for example, my list is a nice easy one. I have five recipes to retest today for Rivers of Flavor: two delectable sweets, a fab pork noodle dish, a salsa variant, and a steamed noodle streetfood from Kengtung. I've got my shopping lists made, and at the other end of the day there are a couple of people dropping by whom I hope to feed with the results of the testing. Getting it done is one goal, but feeding friends is a wonderful motivation for staying on task all day.

Now to jump elsewhere: I went to the Southern Ontario shape-note sing last Saturday. We hold it at the beautiful Detweiler Meeting House southwest of Waterloo, a stone building in rolling farm country that has fabulous acoustics. People came from six states and four provinces, the potluck lunch was a spectacular spread, and the singing warm and intense both. From there I headed to a friend's place north of Lindsey, set in a glade in the woods. I sang to myself as I drove the three hours. I was feeling foolish and over-ambitious, but happily anticipatory too. And it was wonderful to arrive. What an oasis of peace and generous conversation! There was no singing in my sleep, no thought, just a deep plunge.

And that's the other important ingredient to good health, mental and physical: getting rest and sleep. It's while I sleep that my foot and ankle muscles will grow and strengthen. It's when we sleep that our "brain muscles" renew themselves. We're all so ambitious about the things we want to do in the evening. It's as hard to let go sometimes as it was when we were three and were told it was bedtime. "But I'm having so much FUN!"


Travelling Isle said...

Nice post, Naomi. I wish more people knew that you can, and should, strengthen muscles even while you’re injured. It’s not easy to accept since it does go against the grain of normal thinking. If Damien hadn’t taught me non-aggressive back-strengthening exercises, my disc injury, which forced me to lie in pain for weeks, would still be giving me nerve-wracking pain to this day.

naomi said...

Thanks, Ilse. It's so great to see you mobile again. You're so fit, I can't imagine how hard it's been for you all this.
Follow-up: I've now been following the "strengthen the foot regimen for five days. I can already feel the difference in my ankle and foot. I am also feeling way better about it emotionally. It makes me realise how distressing it's been to be hurt.
That in turn is humbling, when I think of the major injuries and physical losses that many people suffer, for various reasons, at any age. Time for me to stop complaining and just get on with it!